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How Physical Therapy Helps Neuropathy

You have gone to the doctor for numbness, tingling, and pain in your hands or feet. The doctor gives you a diagnosis of neuropathy and gives you some home instructions to help with pain and order for physical therapy. This is a good thing because physical therapy helps neuropathy through exercise and modalities. Physical therapists have training in diseases that affect the nerves.  They will be instrumental in helping you understand exactly what is going on and what to do to help it.

What Is Neuropathy?

So, what exactly is neuropathy? According to the International for the Study of Pain, neuropathy is “pain caused by a lesion or disease of the somatosensory nervous system”.  In more understandable terms, the nerves outside of the brain and spinal cord, called peripheral nerves, become damaged. This causes pain and numbness in the hands and feet.

What Are the Symptoms of Neuropathy?

Now that we have an idea of what it is, let’s look at the signs and symptoms of neuropathy. Neuropathy can be a devastating disease that causes pain, tingling, numbness, and loss of sensation usually in the feet and hands. If sensation in the hands and feet disappears, there can be even more significant problems.

Think about this; what if you could not feel your feet. This is a problem that affects your ability to walk, get in or out of a chair, navigate stairs, and tell if your foot is on the gas pedal when driving.  You might run into something that could cause an injury. Your balance will decrease, and you may fall frequently. You could injure your feet without knowing it and suffer a bruise or cut your foot and be unaware of what has happened. Another problem is not being able to find comfortable shoes. You may not be able to feel shoes and if they are ill-fitting, they can cause blisters and may increase your risk of falls if they are too large or too small.

When you have no feeling in your hands, not only does make it hard for you to pick up and hold onto things, but it can be dangerous!  You cannot pick up objects without dropping them so drinking and eating become very difficult.  It is very difficult to button, zip, or tie when getting dressed.  You lose a lot of strength in your hands and wrists which makes cooking or lifting anything very difficult.   You may not be able to feel hot or cold which puts you at risk for burns or frostbite.  So you need to keep an eye on all four extremities to monitor for injuries.

With these types of problems, the quality of life may suffer causing depression and the need for mental health care.

Who Gets Neuropathy?

Neuropathy results from a number of causes.  Some causes can be avoided or controlled and some can’t:

  • Diabetes
  • Chemotherapy
  • Alcohol abuse
  • Vitamin B deficiency
  • Infections
  • HIV/AIDS
  • Exposure to toxins
  • Repetitive motion
  • Genetics

When no clear cause is identified, it is classified as idiopathic neuropathy.

How Do You Manage Neuropathy?

Neuropathy can be difficult to treat as the damaged nerves are unable to heal well.  Unfortunately, it is not something that can be treated with a pill or just by exercising. So, managing the factors you can control is the first and most important thing you can do:

  • Monitor blood sugar levels if you have diabetes
  • Decrease your alcohol intake
  • Increase Vitamin B intake
  • Change how you handle materials to reduce repetitiveness at work
  • Use good hand hygiene and attend to scratches and punctures to reduce risk of infection

Some factors are beyond your control.  So that makes it even more important to be vigilant about factors you can regulate.  The good news is that there are some treatments and therapies are effective to help with neuropathy.

How Physical Therapy Helps Neuropathy 

The best results occur with a comprehensive approach that treats the patient as a whole rather than just one problem at a time. This includes:

Medications:  Many medications are available to assist with the pain and numbness and your doctor will help you find the right medication for you.

Counseling: One treatment that people may not think of when treating neuropathy is psychological help for possible depression that may come with chronic illnesses. A counselor can help you deal with pain and quality of life as you work through your illness.

Pain Clinic:  Other non-pharmaceutical treatments include nerve blocks which block the pain signals that go to the brain, steroid injections that increase the ability of the nerve fibers to receive blood and decrease the pain signals,  and peripheral nerve stimulation or PNS works by stimulating the peripheral nerves to decrease pain.  These treatments are provided by physicians who specialize in pain management and are typically provided at pain clinics.

Physical Therapy:  There is one more treatment that is effective and is frequently ordered by your physician – Physical Therapy! Physical therapy looks at the patient as a whole to find out how neuropathy is affecting your quality of life. After a full evaluation, the physical therapist works with you to find the right treatment to help you. Exercises and balance training are a big part of therapy. Exercises will help keep you strong and keep you from tightness and loss or range of motion. Soft tissue work also helps loosen tight tissues and helps reduce pain. Balance and gait activities helps prevent falls and further injury. TENs (transcutaneous electrical nerve stimulation) blocks the nerve signals to decrease pain. It is an effective treatment that can be easily used at home.  Physical therapy also helps with education about your neuropathy to help you live your best life.

Cold Laser Therapy:  Another newer treatment is LLLT (low-level laser therapy).  It is non-invasive and does not get hot during the treatment. It is a form of phototherapy or photo-biomodulation where non-thermal energy can stimulate biological changes to assist with starting pain relief. Research has found that cold laser not only helps neuropathy pain, but also with wound healing and decreasing muscle and tissue tightness. Cold laser may be a part of the treatment that you receive when you have physical therapy at Therapy Achievements.

What To Do Now?

Your physician and your physical therapist are imperative in assisting you with your neuropathy. It is a difficult problem that gets best results with a team approach to help you with your daily activities. Therapy Achievements is here to give you the treatment and education you need to help you live your best life. Call for an appointment today!

References

Baxter, G. D., Liu, L, Petrich, S., Spontelli Gisselman, A., Chapple, C., Anders, J. J., & Tumilty, S. (2017). Low-level laser therapy (photobiomodulation therapy) for breast cancer-related lymphedema: a systematic review. BMC Cancer, 17(833). https://doi.org/10.1186/s12885-017-3852-x.

Clijsen, R., Brunner, A., Barbero, M., Clarys, P., & Taeymans, J. (2017). Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta-analysis. Edizoni Minerva Medica, 53(4). https://doi.org/10.23736/S1973-9087.17.04432-X

Murnion, B. (2018). Neuropathic pain: current definition and review of drug treatment. Australian Prescriber, 41(3). https://doi.org/10.18773/austprescr.2018.022

Szok, D., Tatjti, J., Nyari, A., & Vecsei, L. (2019). Therapeutic approaches for peripheral and central neuropathic pain. Behavioural Neurology. https://doi.org/10.1155/2019/8685954

(Murnion, 2018; Szok, et al. 2019).

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